Pharmacology/Pharmaceutical Industry
Direct oral anticoagulants for treatment of Heparin-induced Thrombocytopenia
9 Jul, 2017 | 00:35h | UTCDirect oral anticoagulants for treatment of HIT: update of Hamilton experience and literature review – Blood (link to abstract – $ for full-text)
Source: Direct Oral Anticoagulants for Heparin-Induced Thrombocytopenia – Journal Watch ($)
This literature review and observational study suggest direct oral anticoagulants (rivaroxaban, apixaban, dabigatran) are safe and effective for the treatment of Heparin-induced Thrombocytopenia.
Medication nonadherence may increase health care costs
8 Jul, 2017 | 20:19h | UTCLongitudinal Patterns of Medication Nonadherence and Associated Health Care Costs – Inflammatory Bowel Diseases (link to abstract – $ for full-text)
Commentary: Taking medications as prescribed important to control health care costs – Cincinnati Children’s Hospital Medical Center, via EurekAlert (free)
In this small study, patients with increasing nonadherence over time demonstrate more than a 3-fold increase in costs compared with adherent patients.
Lithium Reduces Suicide Risk in Bipolar Patients
7 Jul, 2017 | 14:05h | UTCSuicidal Behavior During Lithium and Valproate Treatment: A Within-Individual 8-Year Prospective Study of 50,000 Patients With Bipolar Disorder – American Journal of Psychiatry (link to abstract – $ for full-text)
Commentaries: Lithium Found to Decrease Suicide Risk in Bipolar Patients – Psychiatry News (free) AND Lithium protects against suicide – Karolinska Institutet News (free)
“Lithium, Not Valproate, Significantly Reduced Suicidal Behavior Among People With BD (an 8 y. Study)” (RT @psychopharmacol see Tweet)
Rivastigmine reviewed: doubts about dementia drug
7 Jul, 2017 | 13:56h | UTCRivastigmine reviewed: doubts about dementia drug – Evidently Cochrane (free)
Related review: Rivastigmine for people with Alzheimer’s disease – Cochrane Library (link to abstract – $ for full-text)
“”Sadly, “small” and “of uncertain clinical importance” are the words chosen by the Cochrane reviewers to describe…” (RT @CochraneUK see Tweet)
Pharmacologic Management of Type 2 Diabetes Mellitus: Available Therapies
7 Jul, 2017 | 13:46h | UTCReview: Pharmacologic Management of Type 2 Diabetes Mellitus: Available Therapies – American Journal of Medicine (free)
Digoxin Use and Subsequent Clinical Outcomes in Patients With Atrial Fibrillation With or Without Heart Failure
5 Jul, 2017 | 18:24h | UTCSource: Hospital Medicine Virtual Journal Club
In this observational analysis, patients with atrial fibrillation without heart failure had increased risk of sudden cardiac death with digoxin use. Among patients with heart failure, digoxin use was associated with an increase in all‐cause death, cardiovascular death, sudden cardiac death, and death caused by HF/cardiogenic shock.
Risk of death among users of Proton Pump Inhibitors
5 Jul, 2017 | 15:31h | UTCCommentaries: Proton pump inhibitors associated with raised mortality – OnMedica (free) AND Longtime use of heartburn drugs linked to increased risk of death – NewsMedical (free) AND People taking heartburn drugs could have higher risk of death, study claims – The Guardian (free) AND Some heartburn drugs linked with higher risk of death – CBS News (free) AND PPIs Linked to Higher Risk for Death – Medscape (free registration required)
In a large observational study, PPI use was associated with increased mortality (HR 1.25; CI 1.23 to 1.28). PPIs were also associated with increased risk compared to H2 blockers (HR 1.24; CI 1.21 to 1.27). See more on the trade-offs of PPI therapy in our July 3rd issue (see #10)
Common ED Medication Errors: Polypharmacy
4 Jul, 2017 | 21:17h | UTCCommon ED Medication Errors: Polypharmacy – emDocs (free)
Related: Current and future perspectives on the management of polypharmacy – BMC Family Practice (free)
High Generic Drug Prices and Market Competition
4 Jul, 2017 | 21:21h | UTCHigh Generic Drug Prices and Market Competition: A Retrospective Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries: Generic drug prices increase when market competition decreases – American College of Physicians, via EurekAlert (free) AND Generic Drug Prices Rise When Market Competition Drops – Medscape (free registration required)
Potential Drug-Drug and Herb-Drug Interactions in Patients With Cancer
3 Jul, 2017 | 17:25h | UTCPotential Drug-Drug and Herb-Drug Interactions in Patients With Cancer: A Prospective Study of Medication Surveillance – Journal of Clinical Oncology (link to abstract – $ for full-text)
Commentaries: Cancer patients should check drug list with pharmacist – Reuters Health (free) AND Cancer Patients’ Drug-to-Drug Interactions Have Consequences – Medscape (free registration required) AND Research Warns Patients of Drug-Drug and Herb-Drug Interactions – AJMC (free)
Complications of Proton Pump Inhibitor Therapy
30 Jun, 2017 | 15:20h | UTCComplications of Proton Pump Inhibitor Therapy – Gastroenterology (free)
Commentary: Complications of Proton Pump Inhibitor Therapy – PracticeUpdate (free registration required)
Related: Deprescribing proton pump inhibitors: Evidence-based clinical practice guideline – Canadian Family Physician (free) AND Proton Pump Inhibitors and Risk of Incident CKD and Progression to ESRD – Journal of the American Society of Nephrology (link to abstract – registration required for full text) AND Association of Proton Pump Inhibitors With Risk of Dementia: A Pharmacoepidemiological Claims Data Analysis – Jama Neurology (link to abstract – subscription required for full text)
The authors of this review argue that the observational studies that brought up the safety issues associated with PPIs (above studies, for example) are insufficient to establish causation and suggest a more balanced approach to PPI prescribing.
Judging the benefits and harms of medicines
30 Jun, 2017 | 15:15h | UTCEditorial: Judging the benefits and harms of medicines – The BMJ (free for 15 days)
“Please read/comment on our editorial @bmj_latest about @acmedsci report on judging benefits and harms of medicines” (RT @fgodlee see Tweet)
Opinion: Natural health products should be sold separately from drugs
26 Jun, 2017 | 18:54h | UTCEditorial: Natural health products should be sold separately from drugs – Canadian Medical Association Journal (free)
“Separate “natural” products from drugs to protect consumers, says @drstanbrook” (RT @CMAJ see Tweet)
Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection
26 Jun, 2017 | 17:52h | UTCSource: EvidenceAlerts (free resource to find articles of interest)
In this meta-analysis including 19 randomized trials, probiotics given within 2 days of the first antibiotic dose (more effective than if started later) reduced the risk of Clostridium difficile infection (CDI) by >50% in hospitalized adults. 1 case of CDI would be prevented for every 23−144 patients treated with probiotics when antibiotics are started. “There was no convincing evidence of superior efficacy for any of the tested probiotic formulations, delivery methods (drink or capsule), or probiotic doses”.
Tamiflu: an expensive lesson in panic stockpiling
26 Jun, 2017 | 13:58h | UTCTamiflu: an expensive lesson in panic stockpiling – Dr Justin Coleman Blog (RT @pash22 see Tweet)
What happens when an expensive drug is approved based on a lower bar of proof?
25 Jun, 2017 | 13:50h | UTCInsurers Battle Families Over Costly Drug for Fatal Disease – The New York Times (10 articles per month are free)
“A new drug can cost over a million dollars, even though it’s unclear if it works. Now, insurers are refusing to pay” (RT @NYTHealth see Tweet)
Update on anti-TNF agents and other new drugs for IBD
23 Jun, 2017 | 13:27h | UTCClinical Review: Update on anti-tumor necrosis factor agents and other new drugs for inflammatory bowel disease – The BMJ (free)
Performance Improvement: Phenytoin Toxicity
22 Jun, 2017 | 00:02h | UTCPerformance Improvement: Phenytoin Toxicity – JAMA (free)
Interesting case of medication error and prevention of subsequent adverse events (RT @JAMA_current see Tweet)
The Challenge of Polypharmacy
21 Jun, 2017 | 15:10h | UTCA medicine review is about stopping medicine as much as it is about prescribing – Royal Pharmaceutical Society of Great Britain (free) (RT @MaryanneDemasi see Tweet)
Original report: The Challenge of Polypharmacy: From Rhetoric to Reality – Royal Pharmaceutical Society and Royal College of General Practitioners Partnership (free PDF)
Related: Current and future perspectives on the management of polypharmacy – BMC Family Practice (free)
The pressure of Big Pharma
21 Jun, 2017 | 02:06h | UTCThe pressure of Big Pharma – The Globe and Mail (a few articles per month are free) (RT @CADTH_ACMTS see Tweet)
“Financial conflicts of interest are commonplace in clinical practice guidelines”
Your vitamin D tests and supplements are probably a waste of money
21 Jun, 2017 | 02:08h | UTCYour vitamin D tests and supplements are probably a waste of money – VOX (free)
Related: Why Are So Many People Popping Vitamin D? – The New York Times (10 articles per month are free)
“Screening for vitamin D has exploded — with no good evidence that it helps people.”
Evolocumab for Treatment of High Cholesterol: Clinical Effectiveness
19 Jun, 2017 | 12:55h | UTCEvolocumab for Treatment of High Cholesterol: Clinical Effectiveness (free PDF) (RT @AnilMakam see Tweet 1, Tweet 2, Tweet 3 and Tweet 4)
News release: Institute for Clinical and Economic Review’s “New Evidence Update” on PCKS9 Inhibitors Highlights Lack of Mortality Benefit With Evolocumab (free)
Lack of mortality benefit in a recent large trial is highlighted in this updated review. Se more on the FOURIER trial and commentaries in our March 20th issue, see #2.
Hundreds died while taking an arthritis drug, but nobody alerted patients
19 Jun, 2017 | 12:47h | UTC
Pain and Opioids in Cancer Care: Benefits, Risks, and Alternatives
16 Jun, 2017 | 01:24h | UTCPain and Opioids in Cancer Care: Benefits, Risks, and Alternatives – 2017 ASCO Educational Book (free)
Age-specific risks, severity, time course, and outcome of bleeding on long-term antiplatelet treatment after vascular events
15 Jun, 2017 | 00:47h | UTCInvited commentary: Preventing major gastrointestinal bleeding in elderly patients (free)
Commentaries: Aspirin Bleeding Risk in Over 75s Higher Than Thought – Medscape (free registration required) AND Aspirin linked to higher risk of serious bleeding in the elderly – Reuters Health News (free)
In this cohort, the risk of major bleeding increased sharply in patients above 75 years.